Loading...
HomeMy Public PortalAbout9709 LONGDEN AVE_Building__ FAM38A 68S-3 12.54 APPLICATION FOR - BUILDING PERMIT DIVISION OF BUILDING AND- SAFETY BUILDING 4 D A 20 Al.D /1/ T, Departnent-of County.Engineer ADDRESS- �' County of Los Angeles LOCALITY '94-111 Ca/�/��1'//6 U WM.J. FOX, COUNTY ENGINEER NEAREST � CASSATT D.GRIFFIN.SUP'T'OF BUILDING /p CROSS ST. ISL OL+ 1 ' DISTRICT NO. GROUP. TYPE SEWER MAP FOR APPLICANT TO FILL IN BK P BUILDIN CONST. ADDRESS L �' MAP . . TAT YES: .NO NUMBER Q� LOT NO. 9 BLOCK USE ZONE SPECIAL g . 'f /' CONDITIONS SCG TRACT �) NO. OF SLOGS. SIZE OF LOT I NOW(bN LOT BUILDING YARDHWYSTREET NAME EXIST. USE OF' SETBACK _!:::: WIDTH EXISTING 8 G. FRONT P. L. Q7 ,C a�0--ow- 0 NER SIDE - - MAIL ) P. L. ADDRESS / TEL. ' t DWELL. I UNIT 5 INDUSTRIAL CITY I NO. 2 DUPLEX_UNIT 6 PUBLIC BLDG. ARCHITECT OR TEL.- ENGINEER EL.ENGINEER 1 N . 3 APT. UNITS 7 ADDN.,ALT., ETC. s ADDRESS / 4 COMMERCIAL 8 MISCEL. TEL. _� CONTRACTOR No. INSPECTION RECORD ADDRESS DESCRIPTION OF WORK" NEW ADD ALTER , "'REPAIR DEMOLISH SQ,FT. NO. OF NO. OF — __ SIZE STORIES /- FAMILIESr� USE OF STRUCTURE / / / (Fs SIGNATURE OF / APPLICANT / '— APPROVALS ADDRESS / jy 7./y DATE INSP CJ R'S SIGNATURE P.C. S FFORMS.rMATERIIALS10N FEE FRAME: FIRE STOPS,G/ $ 0 O BRACING,BOLTS C 7 VALUATION _ FEE FURNACE: LOCATION, v I HEREBY ACKNOWLEDGE. THAT I HAVE READ TH13 GAS VENT, DUCTS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND-AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH, INT. AND STATE LAWS REG .LATING BUILDING CONSTRUC- TION. LATH, EXT. /• .� t SIGNATURE OF HOUSE NUMBER.COR- PERMITTEE C RECT AND POSTED (� J� (' ADDRESSFINAL v 2y��J WK J.:FOX. COUNTY ENGINEER VALIDATION gY ��. a3.fY0.5•IR APR27 1 2.0'0 DEPUTY -• • .DEPUTY BY BY t/ � ' DEPUTY '- DEPUTY 76 bs CEWTeA/7,8) J APPLICATION OR BUIL G ER COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN ADDRESS y, BUILDING / .•^ ADDRESS /d A! a IV Vf` LOCALITY �} �/ NEAREST CITY ZIP -(�10 O CROSS ST. oNO.OF BLDGS. ASSESSOR SIZE OF LOT 3 y ! NOW ON LOT . 3 MAP BOOK GE I PARCEL DISTRICT GROUP TYP F P D BY TRACT BLOCK I LOT NO.- CO • TEL. 15 A OWNER13(11 N0.2 7- 3 'STATISTICAL CLASS( I Tc I�1 � P ADDRESS LD f ouo) AY/Z CLASS NO. ELL.UNITS BK , CITY rn ZIP ��7�� ' ARCHITECT OR TEL. VALUATION $ � ENGINEER NO. ADDRESS BLDG.SETBACK FROM FRONT PROP.LINE OF (STREET) CONTRACTOR NO. HIGHWAY + YARD = TOTAL ACKFROM TYPEOF EXISTING, FRONT PROP.LINE HIG WAY WIDTH ADDRESS NO. LIC. + CITY • - CLASS BLDG.SETBACK FROM CONSTRUCTION LEND FROM S(DE PROP.LINE (STREET( NAME AND BRANCH HIGHWAY +. YARD = TOTAL SETBACK FROM TYPE OF EXISTING ADDRESS CITY SIDE PROP.LINE HIGHWAY WIDTH. C SQ.FT. NO.OF NO.OF CHECK + SIZE STORIES FAMILIES ONE USE ZON M P DESCRIPTION OF WORK /of NEW- ❑ -r N IAL d .szCDEZU%lb el�c ADD ❑ CONDITIONS yll oZ d S lPe/(-•j• ALTER ElFINAL BY ' �,r REPAIR [:] DATE USE OING BLDG. c S l DCt-S DEMOL EXIST ❑ C APPLICANT TEL l (PRINT) NO.2. '_ ` 4 mit 2'980.0A BY ISIGNATUREI IHEREBY ACKNOWLEDGE THAT I HAVE READ IS APPLICATION AND STATE 7 4, G #'Q,o 0 0 0 1 , THAT THE ABOVE IS CORRECT AND AGREE TOC MPLY WITH ALL ORDINANCES n f` ��r W AND LAWS REGULATING BUILDING CONSTRUCTION.I CERTIFY THAT IN DOING THE (•/ V 2 0 0 [I, O 0 WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF - THEATBIOR COD OF THE ON INSURANCE.STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COM- 'Y r. �6 Z5 _ ,06043005 IL SIGNATURE OF ` / 0 (),,1,0 8 0• PERMITTEE ADDRESS _?7102 40A�SQefly f f 011�7 Z TEL. Z� y. Q CITY, NO. f� O P.C.Fee$ Permit Fee > Issuance Fee W 6 Total Feet DIVISION OF BUILDING AND SAFETY BUILDING U ' L® I Department of County.Engineer County of Los Angeles WM. J. FOX, COUNTY ENGINEER APPLICATION FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY DISTRICT NO. PLAN CK.OR REC.No. PERMIT NO. BUILDING /� ADDRESS V '� RECEIVED BY DATE OF ADPL. DATE ISSUED sFi4, LOCALITY xl' -2 ^ �f NEAREST ° Ii�P/Cs /� / /•�� CROBBST. �/B�IILDINd /I'+ �•• yADOREBB �� � / r�� OWNER f //��Cy(iC� �7 '�^� �'`"f��f'"' LOCALITY f r t� ADDRESS NEAREST CITY �/I N0. / !i FIRE NO.OF TYPE GRw U� ARCHITECT OR-' TEL ZONE PLANE v ENGINEER NO. BLDG. ORD. NO. SETBACK LINE ADDRESS USE APPROVED TEL ZONE BY DATE CONTRACTOR NO. HOUSE NUMBERING ADDREB9 MAP NUMBER NO. ASSIGNED BY LEGAL r7 DESCRIPTION LOT NO. ��B�LOC�CK�� CORRECTIONS TRACT A�5/C�L or eLm SIZE OF LOT I NO ON LOT S. USE of I NM DF EXISTING BLDG. FAMILIES DESCRIPTION OF WORK ° NEW ALTFIRATION ADDITION > REPAIR DEMOLITION �• r so.FT. NO.OF /.1 TLF 7'S- `?"'i) ,C? SIZE ROOMS STORIES EXT.WALL I ROOF CCVERJNG COVERING USE QF 9 UL°TURE�� INSPECTION FOR v APPROVALS OCCUPANCYAG INSPECTORIS SIGNATURE DATE FOUNDATION:LOCATION — FORMS, MATERIALS 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- �' ,'� / PLICATION AND STATE THAT THE INFORMATION GIVEN IS FRAME: FIRESTOPB, ` / CORRECT. BRACING,BOLTS ///fvvv�% �_ y 1 AGREE TO COMPLY WITH ALL UOUNTY ORDINANCES FURNACE: LOCATION, AND STATE LAWS REGULATING BUILDING CONSTRUCTION. OAVENT,DUCTS Q, SIGNATURE OF PERMITTLATH, INT. ED � - ADORES '? '70 i` '�ZQ � LATH. EXT. PLASTER, INT. AUTHORIZED ACT. PLASTER, EXT. P.D.rS FEE HOUSE NUMBER COR- RECT AND POSTED / VALUATION FEE $� """' FINAL v 7sA63eA V093 I-sa WORKERS•COMPWSATION,.QECLARATION I, e' affirm that I have r certificate of consent:to self A P P L I CATION FOR BUILDING ' PERMIT' �+ ir}susuFe, or Cg,certificat�f,Worlt�rs'Compensation Insurance, orMcertifie `ictpyereaf(Sec. 3800, Lab. C;)- ie COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company Certified copy is.hereby furnished. FOR APPLICANT,TO FILL IN I BUILDING n . ADDRESS f1 Certified copy is filed with'the county building inspec- BUILDING tion,department. l.._ ADDRESS 12,65 L a vc,6.– LbF E LOCALITY- • NEAREST - Date. Applicant CITY /r Ci% ZIP Q CROSS ST. CERTIFICATE OF..EXEMPTION FROM WORKERS' / /NO.OF BLDGS. pp ASSESSOR ` COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT J P BOOK PAGE PARCEL (This section.need not be completed if the permit is for one I USE ON MAP 1 hundred dollars.($100)or less.) TRACT BLOCK LOT NO. r f NO. TEL. SPECIAL; I certify that in the performance of the work for which this OWNER NO. 2-9-7-13- .i CONDITIONS` f� permit is issued,I shall not employ any person-in any manner C '1 STRICT GR UP TYPE FIRE PRO E. Y ®' so as to become subject to-the Workers'Compensation Laws. ADDRESS =(V. /f: CONST. ZONE' U g � � CITY. M-)41 �% ZIP 7 1', STATISTICAL ATIS� CLASSIFICATION APT., NDO. 0 Date Appplicant ARCHITECT OR TEL. U NOTICE TO APPLICANT: If, after making•this'Certificate"of I. ENGINEER J NO. I 'CLASS NO.. _DWELL. UNITS Ul -Exemption, you should become, subject to the Workers'' H Compensation'provisions of.the Labor.Code, you must faith- j ADDRESS f SEWER MAP with comply•with such provisions or.this-.permit shall be TEL deemed,revoked. CONTRACTOR NO. BK. PG, VALIDATION LICENSED CONTRACTORS DECLARATION ' LIC, I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. VALUATION (commencing with Section 7000)of Division 3 of the Business and LIC., Professions Code, and my license-is in:full force and effect.' CITY CLASS $ pig,100 SQ..FT. II��]]�� NO.OF ," NO.OF CHECII((I' License Number isLc:Clasp SIZE pC(/ STORIES' FAMILIES ONE Y' it $ Contractor' YDate DESCRIPTION OF WORK L ADD ® - am exempt under Sec. - El IS ALTER Q FINAL i v B.BP.C. for this reason ' I s DATE 1 .REPAIR USE OF Date: 'EXISTING BLDG. DEMOL !i 0 By 9 2 6 5,0 A Signature APPLICANT TEL.. ,. OWNER-BUILDER DECLARATION PRINT NO.. a #;'o'0 0 0 0 1 -I hereby affirm that I am exempt from the Contractors License / i; , I -'o 6 a 6 3 Law for'the following'reason (Section 7031.5, 'Business and. ADDRESS . Professions Code),.' ' PRESET 1. b 8 b 3 BUILDING - I, as owner of the property, or'my employees with, ADDRESS O O 98 5 wages as their sole compensation,will do the work and I " the structure isnot intended or offered'for side(Section LOCALITY 1 7044, Business-and Professions Code). f MOVING TEL. u I, as owner of the property,'ani exclusively contracting CONTRACTOR' NO. with licensed contractors to construct the project (Sed- ADDRESS j -tion 7044, Business and Professions Code).' ' Y . REQUIRED TOTAL SETBACK FROM EXIST.' CONSTRUCTION LENDING AGENCY ! SETBACK YARD HW$ PROP, LINE WIDTH w ., I hereby offirm.that there is a construction lending agency for FRONT. I; , the performance of the'work for which'this permit is issued P.L. I tSec. 3097, Civ.'C.). SIDE a - `v Lender's Name P.C. Fee$ ' Permit Fee ; Lender's Address r I certify that I have read this application and state that the Issuance Fee above information is correct:I agree to comply with.all County.. Investigation Fee ordinances and State laws relating to building construction, , Total Fee 0 �O�i• 9 and hereby authorize representatives of this County to enter upo Zv ment�nepr rty,for inspection purposes. - • - •' r4 o '� —�I SEE REVERSE FOR EXPLANATORY LANGUAGE + ®s Signature of Applicant or nt Ddte 011- a� '-WORKEkt'COMPENSATION DECLARATION Fit2refiyirm.tliiit'I have a certificate of consent to self APPLICATION j insure, or a certificate of Workers'Compensation Insurance, + + A P P L I CATION F O It �lU I L D I N G. PERMIT ' . ' or a certified copy'thereof(Sec. 3800, Lab.C. COUNTY OF LOS ANGELES BUILDING + ING AND SAFETY Policy 1V0. Company. ' Certified'copy,is hery unise . BUILDING• Q, ebfrhdFOR APPLICANT TO FILL IN ADDRESS, Cei:tified copy'is filed with the county building inspec- • 't BUILDING a r-� 9 �¢/fes` E ''tion deportment:. 1 ADDRESS 0-/ Lo�C V'v '!/ yL Y "t,' ? Date• Applicant CITY ZIP, '. '� © LOCALITY CERTIFICATE OF,EXEMPTION FROM WORKERS' +f r -NO.OF•BLDGS.' NEAREST COMPENSATION INSURANCE SIZE OF LOT 1. NOW ON LOT CROSS ST. �.'; r ' '(This section„need not be completed if the,permit is for one �. •�+ ASSESSOR hundred dollars'($100)or.less.) - TRACT'. p/” BLOCK L' LOT NO. MAP BOOK PAGE' PARCEL' . TEL. I-certify that'•in the performance of the work for which this .' OWNER �f J�orZ=Z: NO. ��' L USE ZONE - FMA.P,permit is issued, I sFiall not employ'any peisbn in any mtihner r c��/ ECIALADDRESS Q /� ONDITIONS so as to become'subject to the Workers Compensation Laws. �' O - CZ.'. . cITY mac/ zip. v Date Applicant D= NOTICE TO,APPLICANT: If, after mak'irig"this Certificate of. ARCHITECT OR TEL. DISTRICT ' GROUP; TYPE FIREOEDBY. • O ENGINEER .:NO. CONST. ZONE. F-' Exemption, you. should become subject to,;the Workers' QU Compensation provisions.of the Labor Code, you must forth-' S. ADDRESS W with comply with,:such provisions or,this,permit shall be �" deemed revoked. TEL. STATISTICAL CLASS1FI�ATION APT. CONDO. CONTRACTOR NO. +Q,[f�' LICENSED CONTRACTORS.DECLARATION,:. LIC, CLASS NO. ++^^++ DWELL. UNITS' ,I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. commencin with Section 7000 of Division 3 of:the Business and ':i''" SEWER MAP-, , ( 9` )• '.LIC. ; Professions Code,and my license is in full force.arid effect. CITY [9' - CLASS BK. �: VALIDATION: SO:FT NO.OF NO.OF CHECK License.Number Lic.Clcsa t, SIZE, STORIES �' FAMILIES ONE - ff +VALUATION: Cohtrcctor Date DESCRIPTION OF WORK `�AC- ADD ❑❑ 1$ 1 D 0 ❑ I.am exempt under Sec.. a L. a� l x-2- •/ ALTER h. , . B.BP.C. for this reason Q !S•. REPAIR Date:- F', USE OF • 5 r— EXISTING BLDG. DEMOL. APPLICANT TEL. .-Signature I :; � FINAL OWNER-BUILDER DECLARATION PRINT NO. DATE I hereby affirm that I am exempt from the Contractor's License �e Law,for the following reason (Section 7031.5,;Business and , ADDRESS 6 /11 rV FIN -' :,Professions Code):-;. 1',.. PR E ® BUILDING I, as owner of the 'property, or my employees.with(("_ ADDRESS wages as their sole-compensation,will clothe Work and I LOCALITY f ' the structure is not-intended or offered for sale-.(Section 1 7044, Business and Professions Code). i = MOVING TEL. I,.-as owner'of the property,.am exclusively contracting CONTRACTOR NO. ; with licensed contractors,to construct the project'(Sec- ADDRESS ti tion 7044, Business and Professions Code)."' . `�. ' q; $•�]3.>1 A ' REQUIRED TOTAL SETBACK FROM CONSTRUCTION LENDING AGENCY 1' SET BACK YARD HWY PROP.LINE WIDTH # o 0:q o,o,1 I hereby affirm that there is a'coristruction lending agency for,', FRONT the performance of.the work for which this permit is issued . • P.L. (� 6.3 (Sec. 3097, Civ. C.•).• SIDE Lender's Name P.L. L )) 1 e.i o a 6 a 6 3 c $ i/ CDMA Ref. # 2 0;1,0 811, $$ o. ;•' 4 P.C.Fee E. Permit Fee Lender's Address I certify that I have read this application and state that the; - Issuance Fee d `rte CDMA P/C# R . bbove•information is correct. I agree to comply'with oil.County' - Investigation Fee , ordinances and State laws relating to building construction,; i,63 Y ' and hereby'authorize r resentoiives of this County to enter'• Total Fee CDMA.perm.# $' uQon the ab ve=menti ed roperty for•inspection purposes.. I F' " SEE REVERSE FOR EXPLANATORY LANGUAGE f ignatur of Ap icant or r Date ,: